Ceramic on cross-linked polyethylene

BACKGROUND: Highly cross-linked polyethylene (HXLPE) has been an excellent bearing for total hip arthroplasty (THA) due to improved wear characteristics compared to conventional materials. Patients 50 years of age or younger are at high risk for wear-related complications of their THA, and few studies have followed these patients who have HXPLE into the third decade. METHODS: In a retrospective review of 88 consecutive THAs performed in 77 patients aged 50 years and younger (mean 41; range, 20 to 50), in which HXLPE was utilized, they were evaluated for their clinical and radiographic results at an average of 20-year follow-up (range, 18 to 24)...

BACKGROUND: Intra-prosthetic dissociation (IPD) is a complication unique to dual mobility (DM) implants where the outer polyethylene head dissociates from the inner femoral head. Increasing reports of IPD at the time of closed reduction of large head DM dislocations prompted this biomechanical study evaluating the assembly and dissociation forces of DM heads. METHODS: We tested 17 polyethylene DM heads from five vendors. Of the heads, twelve were highly cross-linked polyethylene (4 vendors), and five were infused with vitamin E (2 vendors)...

AIMS: Oxidized zirconium (OxZi) and highly cross-linked polyethylene (HXLPE) were developed to minimize wear and risk of osteolysis in total hip arthroplasty (THA). However, retrieval studies have shown that scratched femoral heads may lead to runaway wear, and few reports of long-term results have been published. The purpose of this investigation is to report minimum ten-year wear rates and clinical outcomes of THA with OxZi femoral heads on HXLPE, and to compare them with a retrospective control group of cobalt chrome (CoCr) or ceramic heads on HXLPE...

INTRODUCTION: Particle-induced osteolysis resulting from polyethylene wear remains a source of implant failure in anatomic total shoulder designs. Modern polyethylene components are irradiated in an oxygen-free environment to induce cross-linking, but reducing the resulting free-radicals with melting or heat annealing can compromise the component's mechanical properties. Vitamin E has been introduced as an adjuvant to thermal treatments. Anatomic shoulder arthroplasty models with a ceramic head component have demonstrated vitamin E-enhanced polyethylene showed improved wear compared to highly cross-linked polyethylene (HXLPE)...

OBJECTIVE: To review research advances of revision surgery after primary total hip arthroplasty (THA) for patients with Crowe type Ⅳ developmental dysplasia of the hip (DDH). METHODS: The recent literature on revision surgery after primary THA in patients with Crowe type Ⅳ DDH was reviewed. The reasons for revision surgery were analyzed and the difficulties of revision surgery, the management methods, and the related prosthesis choices were summarized...

BACKGROUND: There are variations in the performance of individual prostheses used in hip replacements. Some of which have unexpectedly higher revision rates - outliers. The Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) has established a standardised multi-stage approach for identifying these devices. This is done by comparing the revision rates of individual prostheses to all other prostheses in class, with the exception of large head metal-on-metal (LHMoM) prostheses...

Total hip arthroplasty (THA) has in recent years trended toward a younger, more physically demanding patient population. Mid- to long-term studies of all ages of THA patients using highly cross-linked polyethylene (HXLPE) have been favorable, but concerns about its long-term failure and wear-related complications remain for young THA patients. In this narrative review, a search of the PubMed/MEDLINE and Cochrane databases was performed, and we identified six studies with a minimum 15-year follow-up of HXLPE with various femoral head materials...

BACKGROUND: Monoblock ceramic cups are designed to accommodate large-diameter femoral heads (LDHs). This has the potential to offer the advantages of an increased range of motion and enhanced joint stability, with a reduced risk of impingement and dislocation, eliminating the potential of liner malseating, without the associated problems seen in metal-on-metal (MoM) bearings. These features could benefit high-demand patients and are of interest for a growing younger population in need of total hip arthroplasty (THA)...

INTRODUCTION: The management of well-fixed femoral stems in revision total hip arthroplasty (rTHA) remains a subject of debate, with concerns over potential complications arising from stem retention. This study aimed to investigate the re-revision rates due to aseptic loosening of the stem, overall re-revision rates, dislocation rates, and factors influencing these outcomes in rTHA with a retained well-fixed femoral stem. MATERIALS AND METHODS: A systematic search was conducted across several databases including PubMed, EMBASE, and CENTRAL to identify pertinent publications from their inception through 2023...

INTRODUCTION: Atraumatic ceramic femoral head fracture is an uncommon but overwhelming complication of total hip arthroplasty (THA). The complication rate is low, with few reports in the literature. It is critical to continue researching late fracture risk to mitigate these instances. CASE REPORT: A 68-year-old Caucasian female presented with an atraumatic ceramic femoral head fracture in the setting of a ceramic-on-ceramic THA 17 years after primary surgery. The patient was successfully revised to a dual-mobility construct with a ceramic femoral head and a highly cross-linked polyethylene liner...

BACKGROUND: The goals of hip resurfacing are to relieve pain, restore function, and preserve future reconstructive options. Hip resurfacing is an attractive and sometimes the only option when the femoral canal is blocked, making total hip arthroplasty difficult. Hip resurfacing also can be an attractive option for a teenager on the rare occasion when a hip implant is needed. METHODS: A cementless ceramic-coated femoral resurfacing implant matched with a highly cross-linked polyethylene acetabular bearing was used in 105 patients (117 hips) aged 12 to 19 years...

BACKGROUND: The literature has reported that supero-lateralization of the femoral head increases the rates of aseptic loosening and prosthesis revision. However, there are few reports on the influence of different hip center positions on liner wear with more than a 15-year follow-up period. METHODS: From April 2000 to August 2003, 91 patients underwent 108 total hip arthroplasties using a highly cross-linked polyethylene liner combined with Zirconia femoral head and cup components...

INTRODUCTION: Conventional polyethylene (PE) wear has been reported to be associated with femoral offset reconstruction and cup orientation after THA. Thus, the present study aimed (1) to determine the polyethylene wear rate of 32 mm ceramic heads with highly cross-linked polyethylene (HXLPE) inlays up to 10 years postoperatively and (2) to identify patient and surgery-related factors affecting the wear rate. METHODS: A prospective cohort study was performed, investigating 101 patients with 101 cementless THAs and ceramic (32 mm) on HXLPE bearings after 6-24 months, 2-5 years and 5-10 years postoperatively...

BACKGROUND: Highly cross-linked polyethylene (HXLPE) is a widely used bearing surface in total hip arthroplasty (THA); long-term results in young patients are limited. We previously demonstrated excellent results in HXPLE on cobalt-chrome femoral heads at 15-year mean follow-up. The purpose of the present study was to investigate polyethylene wear rates, implant survivorships, wear-related revisions, and patient-reported outcomes (PROs) in a young patient cohort who had alumina ceramic on HXPLE coupling at an average 16-year follow-up...

BACKGROUND: Little is known about retrieved zirconia platelet toughened alumina (ZPTA) wear particles from ceramic-on-ceramic (COC) total hip arthroplasty (THA). Our objectives were to evaluate clinically retrieved wear particles from explanted periprosthetic hip tissues and to analyze the characteristics of in vitro-generated ZPTA wear particles. METHODS: Periprosthetic tissue and explants were received for three patients who underwent a THR of ZPTA COC head and liner...

A new family of environmentally friendly and low-cost membranes based on readily available mineral and polymeric materials has been developed from cast suspensions of kaolin and chitosan using aqueous phase separation and polyethylene glycol as a pore-forming agent. The as-fabricated membranes were further cross-linked with sodium tripolyphosphate (STPP) in order to strengthen the properties of the obtained samples. The functional groups determined by FTIR and EDX confirmed that the reaction occurred. A detailed study of the effects of cross-linking time on the physicochemical, surface and permeation properties showed that a 30-minute reaction enabled the composite membrane to be stable in acidic media (up to pH 2) and increased the mechanical strength twofold compared to the non-cross-linked membrane...

INTRODUCTION: Pediatric hip disorders represent a broad range of pathology and remain a significant source of morbidity for children and young adults. Surgical intervention is often required for joint preservation, but when salvage is not possible, joint replacement may be indicated to eliminate pain and preserve function. Although there have been significant updates in the management of both pediatric hip disease and the field of total hip arthroplasty (THA), there is a paucity of literature reflecting advancements in the area of pediatric and young adult (PYA) arthroplasty...

OBJECTIVES: We aimed to make comparisons of different bearing surfaces in patients after cementless total hip arthroplasty. METHODS: The network meta-analysis was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline. The primary outcomes were implant survival and Harris hip score (HHS). Secondary outcomes included linear wear rates and serum level of metal ions. Subgroup analyses were performed by: 1) classifying head sizes as small and large; 2) femoral heads as ceramic and metal; and 3) liners as metal, ceramic, polyethylene, highly cross-linked polyethylene (HXP), or vitamin E-infused highly cross-linked polyethylene (HXPE)...

BACKGROUND: Wear between the femoral head and acetabular liners continues to limit the longevity of total hip arthroplasty (THA) implants despite advances in implant materials. The purpose of this meta-analysis was to compare linear wear rates of cobalt-chromium (CoCr) and fourth-generation ceramic femoral heads on highly cross-linked polyethylene (XLPE) liners. METHODS: A systematic review following PRISMA guidelines was conducted to identify all studies between 2003 and 2020 that examined in vivo wear rates of either 4th generation ceramics or CoCr femoral heads on XLPE liners...

Chondral lesions caused by stressors, such as injury or inflammation, lead to osteoarthritis (OA). OA is a degenerative joint disease that has become a challenge worldwide. As the articular cartilage is incapable of self-regeneration due to the absence of vessels and nerves, novel cartilage repair techniques are urgently needed. Three-dimensional (3D) bioprinting, which allows the precise control of internal architecture and geometry of printed scaffolds, has stepped up to be a promising strategy in cartilage restoration...